神经发育障碍儿童攻击行为干预的研究进展

摘要/Abstract

摘要：

攻击行为在神经发育障碍儿童中普遍存在，对个人、家庭和社会造成严重影响。因此，针对此行为干预方法成为研究的重点。本综述系统归纳和总结神经发育障碍儿童攻击性行为的不同干预方法，为临床实践提供参考和指导。基于应用行为分析原理的功能分析和功能性治疗在减少或消除攻击性行为方面具有明显效果，包括事前干预、强化策略、后效控制及行为减少策略等，在减少或消除神经发育障碍儿童的攻击性行为方面具有明显效果。事前干预主要关注先行因素，例如通过教授社交技巧和情绪调节策略来降低攻击倾向；强化策略通过奖励和惩罚来塑造行为模式；后效控制则管理行为后果，训练替代行为减少攻击；行为减少策略则通过应用消退和惩罚消除不良行为。针对神经发育障碍儿童攻击行为的干预方法需要综合考虑个体差异、家庭和社会环境等多方面因素，早期和有效的行为干预对改变行为至关重要。未来的研究应进一步探索不同干预方法的适用性和有效性，以提供更加科学和有效的治疗方案。

关键词: 攻击行为, 行为干预, 神经发育障碍, 儿童

Abstract:

Aggressive behavior is prevalent in children with neurodevelopmental disorders and presents serious impact on individuals， families， and society. Therefore， the intervention methods for this behavior have become the focus of relevant researches. This review systematically summarizes various intervention methods for aggressive behavior in children with neurodevelopmental disorders to provide reference and guidance for clinical practice. It is found that functional analysis and functional-based treatment based on applied behavior analysis （ABA） principles have significant effects in reducing or eliminating aggressive behavior. Such treatments， including antecedent interventions， reinforcement strategies， contingency strategies， and behavior reduction strategies， can significantly reduce or eliminate the aggressive behaviors in children with neurodevelopmental disorders. Antecedent interventions focus on antecedent factors， such as reducing aggressive tendencies by teaching social skills and emotion-regulation strategies. Reinforcement strategies shape behavior patterns through reinforcement and punishment. Contingency strategies manage the consequences of behaviors and help establish alternative behavior to reduce aggression. Finally， behavior reduction strategies aim to eliminate undesirable behavior through the application of extinction and punishment. The intervention methods for the aggressive behavior of children with neurodevelopmental disorders need to be comprehensively adjusted for individual differences and social environment. Early and effective behavioral intervention is crucial to behavior change. Future studies should further explore the applicability and effectiveness of different intervention methods to provide evidence-based and effective treatment options.

Key words: Aggressive behavior； , Behavior intervention； , Neurodevelopmental disorders； , Children

中图分类号:

R741
R729

王梓, 岳计辉, 方晓娟.

神经发育障碍儿童攻击行为干预的研究进展 [J]. 中国医药导刊, 2024, 26(4): 353-358.

WANG Zi, YUE Jihui, FANG Xiaojuan.

Research Progress on Intervention for Aggressive Behavior of Children with Neurodevelopmental Disorders [J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2024, 26(4): 353-358.

参考文献

［1］朱红敏，袁纯辉，刘智胜. 儿童神经发育障碍疾病研究进展［J］. 中国当代儿科杂志， 2023，25（1）：91-97.

［2］陈静， Garralda MElena，程文红. ICD-11精神与行为障碍（草案）关于神经发育障碍诊断标准的进展［J］. 中华精神科杂志， 2017，50（6）：411-413.

［3］ Bitta M， Kariuki SM， Abubakar A， et al. Burden of neurodevelopmental disorders in low and middle-income countries： a systematic review and meta-analysis［J］. Wellcome Open Res， 2017，2：121.

［4］ Baio J， Wiggins L， Christensen DL， et al. Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network， 11 Sites， United States， 2014［J］. MMWR Surveill Summ， 2018，67（6）：1-23.

［5］ Zablotsky B， Black LI， Maenner MJ， et al. Prevalence and trends of developmental disabilities among children in the United States： 2009-2017［J］. Pediatrics， 2019，144（4）：e20190811.

［6］ Al-Wardat M， Etoom M， Almhdawi KA， et al. Prevalence of attention-deficit hyperactivity disorder in children， adolescents and adults in the Middle East and North Africa region： a systematic review and meta-analysis［J］. BMJ Open， 2024，14（1）：e078849.

［7］ Wang T， Liu K， Li Z， et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China： a systematic review and meta-analysis［J］. BMC Psychiatry， 2017，17（1）：32.

［8］ Newcomb ET， Hagopian LP. Treatment of severe problem behaviour in children with autism spectrum disorder and intellectual disabilities［J］. Int Rev Psychiatry， 2018，30（1）：96-109.

［9］ Oubrahim L， Combalbert N. Frequency and origin （reactive/proactive） of aggressive behavior in young people with intellectual disability and autism spectrum disorder［J］. Int J Dev Disabil， 2019，67（3）：209-216.

［10］ Antonacci DJ， Manuel C， Davis E. Diagnosis and treatment of aggression in individuals with developmental disabilities［J］. Psychiatr Q， 2008，79（3）：225-247.

［11］ Kurtz P F， Leoni M， Hagopian LP. Behavioral approaches to assessment and early Intervention for severe problem behavior in intellectual and developmental disabilities［J］. Pediatr Clin North Am， 2020，67（3）：499-511.

［12］ Mueller MM， Wilczynski SM， Moore JW， et al. Antecedent manipulations in a tangible condition： effects of stimulus preference on aggression［J］. J Appl Behav Anal， 2001，34（2）：237-240.

［13］ Oliver AC， Pratt LA， Normand MP. A survey of functional behavior assessment methods used by behavior analysts in practice［J］. J Appl Behav Anal， 2015，48（4）：817-829.

［14］ Wood LC ，Kisinger WK ，Brosh RC ， et al. Stopping behavior before it starts： antecedent interventions for challenging behavior ［J］. Teaching Exceptional Children， 2018， 50 （6）： 356-363.

［15］ Horner RH， Carr EG， Strain PS， et al. Problem behavior interventions for young children with autism： a research synthesis［J］. J Autism Dev Disord， 2002，32（5）：423-446.

［16］ Koegel LK ， Stiebel D ， Koegel RL .Reducing aggression in children with autism toward infant or toddler siblings［J］.Research and Practice for Persons with Severe Disabilities， 1998， 23（2）：111-118.

［17］ McComas J， Hoch H， Paone D， et al. Escape behavior during academic tasks： a preliminary analysis of idiosyncratic establishing operations［J］. J Appl Behav Anal， 2000，33（4）：479-493.

［18］ Borrero CSW ， Vollmer TR ， Borrero JC .Combining descriptive and functional analysis logic to evaluate idiosyncratic variables maintaining aggression［J］.Behavioral Interventions， 2010， 19（4）：247-262.

［19］ Brosnan J， Healy O. A review of behavioral interventions for the treatment of aggression in individuals with developmental disabilities［J］. Res Dev Disabil， 2011，32（2）：437-446.

［20］ Cooper SA， Smiley E， Jackson A， et al. Adults with intellectual disabilities： prevalence， incidence and remission of aggressive behaviour and related factors［J］. J Intellect Disabil Res， 2009，53（3）：217-232.

［21］ Fuhrman AM， Greer BD， Zangrillo A N， et al. Evaluating competing activities to enhance functional communication training during reinforcement schedule thinning［J］. J Appl Behav Anal， 2018，51（4）：931-942.

［22］ Martha C， Sylvia BD， Samuel H， et al. A medical school's approach to meeting the challenges of interdisciplinary global health education for resident physicians［J］. Educ Health （Abingdon）， 2016，29（2）：113-118.

［23］ Aguirre L， Hendelman A， Hutton SF， et al. Idiosyncratic and dose-dependent epistasis drives variation in tomato fruit size［J］. Science， 2023，382（6668）：315-320.

［24］ Alakhzami M， Chitiyo M. Using Functional communication training to reduce delf-injurious behavior for individuals with autism spectrum disorder［J］. J Autism Dev Disord， 2022，52（8）：3586-3597.

［25］ Tiger JH， Hanley GP， Bruzek J. Functional communication training： a review and practical guide［J］. Behav Anal Pract， 2008，1（1）：16-23.

［26］ DeLeon IG， Fisher WW， Herman KM， et al. Assessment of a response bias for aggression over functionally equivalent appropriate behavior［J］. J Appl Behav Anal， 2000，33（1）：73-77.

［27］ Johnson L， McComas J， Thompson A， et al. Obtained versus programmed reinforcement practical considerations in the treatment of escape-reinforced aggression［J］. J Appl Behav Anal， 2004，37（2）：239-242.

［28］ Roscoe EM， Kindle AE， Pence ST. Functional analysis and treatment of aggression maintained by preferred conversational topics［J］. J Appl Behav Anal， 2010，43（4）：723-727.

［29］ Walker VL， Lyon KJ， Loman SL， et al. A systematic review of Functional Communication Training （FCT） interventions involving augmentative and alternative communication in school settings［J］. Augment Altern Commun， 2018，34（2）：118-129.

［30］ Chowdhury M， Benson BA. Use of differential reinforcement to reduce behavior problems in adults with intellectual disabilities： a methodological review［J］. Res Dev Disabil， 2011，32（2）：383-394.

［31］ Geiger F， Bengtsson J， Berendse F， et al.Persistent negative effects of pesticides on biodiversity and biological control potential on European farmland［J］.Basic & Applied Ecology， 2010， 11（2）：97-105.

［32］ Ringdahl JE， Call NA， Mews JB， et al. Assessment and treatment of aggressive behavior without a clear social function［J］. Res Dev Disabil， 2008，29（4）：351-362.

［33］ Phillips LA， Fritz JN， Rettig LA， et al. Diaphragmatic breathing as treatment for escape-maintained aggression［J］.Behavioral interventions， 2019， 34（2）：216-230.

［34］ Carr JE， Coriaty S， Wilder DA， et al. A review of "noncontingent" reinforcement as treatment for the aberrant behavior of individuals with developmental disabilities［J］. Res Dev Disabil， 2000，21（5）：377-391.

［35］ Lindberg JS， Iwata BA， Roscoe EM， et al. Treatment efficacy of noncontingent reinforcement during brief and extended application［J］. J Appl Behav Anal， 2003，36（1）：1-19.

［36］ Dupuis DL， Lerman DC， Tsami L， et al. Reduction of aggression evoked by sounds using noncontingent reinforcement and time-out［J］. J Appl Behav Anal， 2015，48（3）：669-674.

［37］ Hood SA， Rodriguez NM， Luczynski KC， et al. Evaluating the effects of physical reactions on aggression via concurrent-operant analyses［J］. J Appl Behav Anal， 2019，52（3）：642-651.

［38］ Lalli JS， Casey SD， Kates K. Noncontingent reinforcement as treatment for severe problem behavior： some proceduralvariations［J］. J Appl Behav Anal， 1997，30（1）：127-137.

［39］ Thompson RH， Fisher WW， Piazza CC， et al. The evaluation and treatment of aggression maintained by attention and automatic reinforcement［J］. J Appl Behav Anal， 1998，31（1）：103-116.

［40］ O'Reilly M， Lancioni G， Taylor I. An empirical analysis of two forms of extinction to treat aggression［J］. Res Dev Disabil， 1999，20（5）：315-325.

［41］ Lerman DC， Iwata BA. Prevalence of the extinction burst and its attenuation during treatment［J］. J Appl Behav Anal， 1995，28（1）：93-94.

［42］ DeLeon IG， Kahng S， Rodriguez-Catter V， et al. Assessment of aberrant behavior maintained by wheelchair movement in a child with developmental disabilities［J］. Res Dev Disabil， 2003，24（5）：381-390.

［43］ Saini V， Greer BD， Fisher WW. Clarifying inconclusive functional analysis results： assessment and treatment of automatically reinforced aggression［J］. J Appl Behav Anal， 2015，48（2）：315-330.

［44］ Lerman DC， Iwata BA， Wallace MD. Side effects of extinction： prevalence of bursting and aggression during the treatment of self-injurious behavior［J］. J Appl Behav Anal， 1999，32（1）：1-8.

［45］ Matson JL， Boisjoli JA. The token economy for children with intellectual disability and/or autism： a review［J］. Res Dev Disabil， 2009，30（2）：240-248.

［46］ Randall KR， Lambert JM， Matthews MP， et al. Individualized levels system and systematic stimulus pairing to reduce multiply controlled aggression of a child with autism spectrum disorder［J］. Behav Modif， 2018，42（3）：422-440.

［47］ Tarbox J， Tarbox C.Training manual for behavioral technicians working with individuals with autism［M］. 2017：11-18.

［48］ Ringdahl JE， Christensen TJ， Boelter EW.Further evaluation of idiosyncratic functions for severe problem behavior： aggression maintained by access to walks［J］.Behavioral Interventions， 2009， 24（4）：275-283.

［49］ Vollmer TR， Hagopian LP， Bailey JS， et al. The association for behavior analysis international position statement on restraint and seclusion［J］. Behav Anal， 2011，34（1）：103-110.

［50］ Lerman DC， Vorndran CM. On the status of knowledge for using punishment implications for treating behavior disorders［J］. J Appl Behav Anal， 2002，35（4）：431-464.

快速检索引用检索图表检索高级检索